MEDICARE: RIVER CITY CONVENIENT CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	1611	TN

General Provider Information

NPI Number	:	1790718898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER CITY CONVENIENT CARE

Provider Business Mailing Address
First Line	:	1960 PICKWICK ST
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-5309
Country	:	US
Telephone Number	:	731-925-1911
Fax Number	:	731-925-1912

Provider Business Practice Location Address
First Line	:	1960 PICKWICK ST
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-5309
Country	:	US
Telephone Number	:	731-925-1911
Fax Number	:	731-925-1912

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. RENA DELL SALYER
Credential	:	D.O.
Telephone Number	:	731-925-1911

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/25/2008

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Directions to “RIVER CITY CONVENIENT CARE ” Practice Location

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